Can the Retiree Health Benefits Provided By Your Employer Be Cut?

Authored By:
U.S. Department of Labor

Information

Can the Retiree Health Benefits Provided ByYour Employer Be Cut?

Background

Providing for health care is an important part of retirement. Some employees are fortunate: they belong to employer-providedhealth care plans that carry over to retirement. However an important question arises for employees and retirees: How secure are my health care benefitsafterretirement? Under what circumstances can the company reduce or terminate my health benefits?

Employees and retirees should know that private-sector employers are not required to promise retiree healthbenefits.Furthermore,whenemployers do offer retiree healthbenefits,nothinginfederallawprevents them from cutting or eliminating those benefits--unless they have made a specific promise to maintain the benefits.

Review Your Plan Documents

To understand the terms of employer-provided retiree health benefits, you should first review your plan documents.

The Summary Plan Description (SPD) is a summary of the terms of the plan. Employers are required to provide a copy to you within 90 days after you become a participant in the plan.

For retirees, the SPD that was in effect when you retired may be the controlling document.You should save a copy of it.You also should save any SPD changes affecting your benefits after you retire.

In addition, there may be formal written documents that outline how your health plan is operated.These may include a collective bargaining agreement or an insurance contract.

You Should Know -- Coverage can Change

If your employer has reserved the right in the SPD or controlling plan document to change the terms of the plan, you may lose coverage at any time during your retirement. If your employer made a clear promise that you will have specific health carebenefits for a definite period of time or for life, and did not reserve the right to change the plan in any formal written plan document, you should be covered.

What To Look For In Plan Documents

Check all your plan documents with the following questions in mind:

Do the SPD or other plan documents promise that health benefits after retirement will continue at a specified level fora certain period of time?

If there is no specific language describing retiree health benefits in your plan documents, it is unlikely that you have guaranteed coverage.

if there is such language, how specific is it?

Sometimes language covering retiree health benefits is included in the documents, but it is too vague to stand up to a test in the courts. Conversely, there is language on

employee health benefits that has held up in court. Here is an example:

“Basic health care coverage will be provided at the company’s expense for your lifetime.”

Even if a specific promise is made, is there also language that gives your former employer the right to change or terminate that specific promise or to amend or terminate the entire plan?

Typical language giving theemployer that right might read:

“The company reservesthe right to modify, revoke, suspend, terminate or change the program, in whole or inpart, at any time.”

This is an actual example, but other similar language may be found anywhere in the plan documents.

If you are an employee reviewing the current plan, it is important to remember that it can change in the future.The documents in effect when you retire may be the ones that will determine your health benefits,if any, in your retirement. However,court rulings in these matters have not been uniform.

What if the Language is Conflicting or Ambiguous?

Benefit plan documents are often not easy to interpret, and the language described above, providing an employer's right to change benefits may be ontined in any part of the documents.

Some courts may not enforce what seems like clear "promise" language if the plan document contains general language reserving the employer's right to amend or terminate the plan.

On the other hand some courts have enforced clear promise language in an SPD, evein in cases where the plan document containted a right by the employer to amend the promise.

YOU NEED TO CHECK ALL DOCUMENTS

Review Any Employer Communications on Retiree Health Benefits

You should obtain whatever information is available indicating the intentions of your former employer with respect to retiree health care benefits.

You should know that some courts may take into account any informal communications that you have had with your employer concerning retiree health care benefits, at least where the plan document and SPD are ambiguous.

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